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CHICAGO — One in five heart defibrillators may be implanted for questionable reasons without solid evidence that the device will help, according to a first-of-its-kind analysis.

Implanted defibrillators shock the heart back into a normal rhythm when it starts beating irregularly. They can prevent sudden death in people with advanced heart failure, but researchers have not found a benefit for other patients.

Patients who have had a recent heart attack or recent bypass surgery aren’t good candidates for defibrillators, for example. Guidelines do not recommend them for people newly diagnosed with heart failure, either.

But in the new study, which examined nearly four years of national data, 22 percent of the implant surgeries were in patients who fit one of those categories.